In the decade 1993-2003 health funding saw real terms growth across the OECD area. Only in Finland did the health share of GDP fall during this decade (Table 1). This period of relatively rapid growth is highly likely to have brought on a phase of cost containment through pressure on funders ability to pay — but this time there was additional pressure from changing perceptions of the longer term pressures on health services. The concerns are no longer just about the supply side and short term cost containment — they have shifted towards a new set of concerns about the future demand for health. Future demography has for long been presented as a nightmare with rising support costs for more elderly people: but in addition there are new and unsettling concerns about lifestyle changes which affect all age groups.